Image-Sharing Network Allows Patients to take Control of their Medical Exam Records

An image-sharing network enables patients to securely store, manage, and share their imaging records through the Internet using personal health record accounts. The network is meeting patient expectations regarding ease of access, timeliness, and privacy.

Patients place importance on direct, independent access to their medical exams, according to a new study presented at the annual meeting of the Radiological Society of North America (RSNA), held in Chicago (IL, USA), from November 30 through December 5, 2014.

Fragmentation of health data among physicians, healthcare institutions or practices, and inefficient exchange of test results can decrease quality of care and contribute to high medical costs. Improving communications and giving patients more control over their care are critical objectives of health information technology (IT) initiatives.

“Easy and timely electronic access to an online unified source of radiologic exams under a patient’s direct control can potentially improve healthcare quality, enhance the patient’s engagement in their medical care, and reduce unnecessary imaging utilization and exposure to ionizing radiation,” said Giampaolo Greco, PhD, MPH, assistant professor in the department of population health science and policy at the Mount Sinai School of Medicine (New York, NY, USA).

Dr. Greco and colleagues set out to evaluate patient and provider satisfaction with the use of RSNA Image Share, an Internet-based interoperable image exchange system that gives patients ownership of their imaging exams and control over access to their imaging records. The network enables radiology sites to make imaging scans available for patients to integrate into personal health record (PHR) accounts they can use to securely store, manage, and share their imaging records. Sites can also use the network to send patient imaging records to other participating sites to support better informed care.

Compared to other systems based on point-to-point private networks, the RSNA Image Share system avoids the legal delays and expenses linked with virtual private networks and enables the same flexibility of access characteristic of physical media such as CDs. Patients who use this system have the ability to allow any provider they wish to access their images, as they do with CDs. “This is a standards-based solution designed to achieve full interoperability of health information technology systems. Anyone, physician or other, no matter their location or affiliation, can view the images with proper patient authorization,” Dr. Greco said.

Patients, for the study, undergoing any radiologic exams in four academic centers were eligible to establish online PHR accounts using the RSNA Image Share network. Patients could then use their PHR accounts to maintain and share their images with chosen providers, creating a detailed medical history accessible through any secure Internet connection.

Between July 2012 and August 2013, the study enrolled 2,562 patients, mean age 50.4, including a significant a segment of older individuals. Older individuals have the highest healthcare utilization and frequently experience or perceive a significant obstacle in using information technology. “The high level of enrollment among people in this age group demonstrates their interest in tools that may facilitate the management of their complex medical records and communication with their providers,” Dr. Greco said.

The median number of exams uploaded per patient was six. Study participants were provided a short survey to assess patient and physician experience with the exchange of images, and 502 patients completed and returned their surveys. Of these, 448 patients identified the technique used at the visit to share images: Internet, CDs, both Internet and CDs, or other, and 165 included a section completed by their physician.

Almost all (96%) of the patients responded positively to having direct access to their medical images, and 78% viewed their images independently. There was no difference between Internet and CD users in satisfaction with privacy and security and timeliness of access to medical images. A greater percentage of Internet users reported being able to access their images without difficulty, compared to CD users (88.3% vs. 77.5%).

“We found almost unanimous agreement from patients on the value of having direct, independent access to their imaging exams,” Dr. Greco concluded. “This report shows that an image-sharing solution that is patient-directed and Internet-based is feasible and not only facilitates access, but also, with respect to privacy and security, generates the same level of user satisfaction as that attained through CDs.”

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Mount Sinai School of Medicine